How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $15.49 Median $19.50 Typical High $37.15 | Facility | None | $15.49 | $19.50 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $27.54 Typical High $36.31 | Professional | None | $15.49 | $27.54 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $42.66 Typical High $56.23 | Professional | None | $19.50 | $42.66 | $56.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $16.22 Median $30.90 Typical High $39.81 | Professional | None | $16.22 | $30.90 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $25.70 Typical High $66.07 | Facility | None | $18.20 | $25.70 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $32.36 Typical High $69.18 | Professional | None | $18.62 | $32.36 | $69.18 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $181.97 Typical High $1,288.25 | Facility | None | $54.95 | $181.97 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $162.18 Typical High $338.84 | Professional | None | $38.02 | $162.18 | $338.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $19.95 Median $41.69 Typical High $64.57 | Professional | None | $19.95 | $41.69 | $64.57 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $13.80 Typical High $16.98 | Professional | 52 · Reduced service | $7.76 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.50 Typical High $6.76 | Professional | 53 · Discontinued | $3.16 | $5.50 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $4.07 Typical High $5.13 | Professional | 55 · Aftercare only | $2.34 | $4.07 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.75 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.58 | $2.75 | $3.39 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 13th of 51
$44.67
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.